安寧療護提供哪些服務？

If you or your loved one has been told it's time for hospice, you may be bewildered, thinking, "What does hospice do?" "How does hospice work?" You may have heard hospice means giving up, or think that it will hasten death. But being admitted into hospice care means neither of these things; in fact, its purpose is to improve the quality of life for the patient with life-limiting illness and their family.

什麼是安寧療護？

When treatment for a terminal illness is no longer working, patients may elect to forego treatment. Hospice is a philosophy of care that enables these patients to live out the rest of their lives in dignity, with pain and other symptoms managed. Hospice care focuses on making life better-physically, emotionally and spiritually-for patients and their families.

A medical subspecialty, hospice manages the symptoms of complex illnesses and conditions to keep the patient comfortable. For example, the physician and nurse on the patient's hospice team are well-qualified to administer high-flow oxygen therapy to patients with advanced respiratory disorders to relieve distressing respiratory symptoms at home. The hospice team is trained to evaluate ethical medical issues at the end of life, such as the use of a ventilator or treating an infection, and discuss them fully with the family.

The goal of hospice is to improve the quality of life for patients near the end of life, and to ensure a gentle, peaceful death at home, where we all feel happiest and safest.

What Happens in Hospice Care?

When a patient is admitted into the care of hospice, they are provided with everything needed to manage their terminal illness. This includes being under the care of an interdisciplinary team of hospice professionals-physician, nurse, hospice aide, social worker, chaplain, volunteer and bereavement specialist. Hospice provides all prescription drugs, over-the-counter medications, medical equipment and supplies required to manage the hospice diagnosis.

Hospice is about improving quality of life. The patient and family are visited by various members of the hospice team, each bringing their own special services. The nurse may monitor vital signs, dress skin ulcers or sores, administer pain medication or address other symptoms. The aide may offer bathing and mouth care. The team's chaplain may be invited to pray with the patient and family; the volunteer may create a journal of the patient's life. Sometimes a team member will sit quietly by the bedside and listen, or share a cup of coffee with the caregiver.

If symptoms are exacerbated, hospice can provide temporary shifts of 24-hour care in the home until the symptoms are managed. If medically necessary, hospice provides inpatient hospice care in a health facility.

What is the Purpose of Hospice Care?

To bring quality of life to terminally ill patients.

Undergoing the relentless battle against a terminal illness often brings exhaustion, discomfort, pain and humiliating treatments, robbing an individual of time and relationships with those they love. Choosing hospice isn't giving up, it's choosing to live out your life in comfort and dignity, surrounded by the people, pets and things you love.

In addition to offering a better quality of life, hospice can add more time to a terminally ill patient's life, in some cases. Studies reveal that hospice may prolong the lives of terminally ill patients by as much as 29 days.¹ Hospice takes the focus off the disease and puts it on the patient, to ensure they are experiencing all life offers them.

To place the patient in control.

Terminally ill patients have generally experienced years of curative treatments. These can be invasive, uncomfortable or painful and leave the patient exhausted and susceptible to other illnesses. It can be overwhelming to listen to doctors and loved ones express their opinions about the best course of action. The patient can feel they are losing control of their life as they slowly lose control of their body and situation.

Hospice allows terminally ill patients to make decisions about their treatment and how they want to live for the months, weeks or days they have left. Hospice gives patients choices; it leaves them in control.

To support the caregiver and the family.

Becoming a full-time caregiver to a loved one who is dying is one of life's most stressful situations. Not only must the caregiver face the reality of the terminal illness, but there is also the challenge of administering medications properly, making difficult decisions, keeping the bills paid and the home running.

The hospice philosophy of physical, emotional and spiritual care extends to the patient's caregiver and family members. The members of the care team are there to assist the family however they can to help reduce the burden of care. The hospice nurse teaches the caregiver how to take care of the patient. The hospice aid takes on some of the patient's personal care and can lend a hand with light housekeeping or shopping. The volunteer on the team can sit with the patient to allow the caregiver time to take a breather. The social worker might help with financial decisions, community resources or funeral planning. The chaplain can work with the family's clergy or alone to comfort and answer difficult spiritual questions. After the death, the caregiver and family receive scheduled calls and/or visits from the bereavement specialist or chaplain. They can take advantage of grief support for more than a year. Even after this time has passed, caregivers and family members are encouraged to contact the hospice if they need additional help.